A wide variety of equipment and procedures have previously been used to perform tenorrhaphy, the union of a divided or ruptured tendon by a suture and tenodesis, the suturing of the end of a tendon to a bone. Over the past decade, several multiple grasping, multiple strand suture techniques have been developed to repair tendon lacerations. These techniques are based on the concept that repair strength is roughly proportional to the number of suture strands that cross the repair site. In addition, suturing techniques that appropriately grasp a tendon at multiple sites generally create a stronger repair than a simple weave.
Although these repair techniques provide greater strength, their use has not been widespread because they are technically quite demanding. In fact, even traditional methods of tendon repair are difficult to satisfactorily perform due to the small size and other characteristics of tendons and the correspondingly small surgical field. The technique of tendon repair has become an even greater concern due to demands placed on such repairs by aggressive rehabilitation. Thus, surgeons face the dilemma of using stronger suture techniques to improve outcome but which are also much more difficult and time-consuming to perform and may possibly cause additional damage to the tendon.
During tendon repair, it is important to minimize any further damage to a lacerated tendon. The lacerated ends of a tendon tend to fray when handled, especially when an attempt is made to place multiple sutures in the lacerated end of the tendon. In addition, surgical trauma increases postoperative adhesions possibly resulting in decreased digital motion which is undesirable.